McGill Case 191

This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia. Previous Case: McGill Case 190 | Next Case: McGill Case 192

This recording shows sinus rhythm with premature atrial complexes. The p' wave can be seen deforming the T wave in the lead II rhythm strip. Note also that the atrial premature complexes reset the sinus node and hence there is no compensatory pause before the next sinus p wave. The QRS is deformed with a rsR' in V1 and a broad S in I with a duration of > 120 ms. diagnostic of aberrance with a right bundle branch morphology. The S1 Q3 and the right ward axis of the aberrant complexes suggest an additional left posterior fasicular block.